Seventeen cases of chronic (relapsing) appendicitis, treated by operation / by Hunter McGuire.

  • McGuire, Hunter Holmes, 1835-1900.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Seventeen cases of chronic (relapsing) appendicitis, treated by operation / by Hunter McGuire. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    second seizure never come on, and a patient is entitled to that chance, if he so decide. But if the attacks are repeated, and es- pecially if the intervals between are becoming shorter, and the attacks more violent, then the appendix should be removed. The next attack may be fatal, or at least the man becomes a hopeless invalid. Ever since Escherich discovered the microbe, which he called bacillus coli communis, it has been almost conclusively demon- strated that this bacillus is the genesis of a certain number of maladies, and chief among them is appendicitis. This micro-or- ganism has its domicile in the digestive track of man and ani- mals, extending from the mouth to the anus. They were'for a time regarded as not only inoffensive, but positively useful in the ani- mal economy; but it has been discovered that, under certain cir- cumstances, these microbes may become very virulent and hurt- ful. Any morbid condition of the bowels makes them virulent; inflammation, obstruction, strangulation, diarrhoea, or constipa- tion, may render this bacillus virulent. Constipation is a com- mon cause; indeed, a very large proportion of the cases of all kinds of appendicitis that I have seen were subjects of habitual constipation. The bacillus coli is generally found in cases of ap- pendicitis alone, or sometimes associated] with other pathogenic germs. The pathological conditions, following one or more attacks of appendicitis, can be partially gathered from the report of my cases. The appendix may be fastened like a strap across the CEecum interfering with the peristalsis of the gut; it ma}'^ be fixed by adhesions to other parts; it may be bent upon itself, and its lumen occluded by kinking; a portion of the canal may be ob- literated and closed at itscaecal end, and the distal end distended to several times its natural size, and filled with mucus or pus, or both; a small abscess may be found around the appendix, walled off strongly by a barrier of well-organized fibrin; or else it is said a foreign body may occupy its canal. I have never seen the last; I have seen soft fsecal matter lying in the canal, and seve- ral times hard dry balls of ffecal matter. In one case in Staun- ton, Va., where I operated for acute appendicitis on a physician’s son, the doctor.opened the appendix before I completed the oper-